The U.S. Court of Appeals for the Seventh Circuit has ruled in favor of three transgender students who were forbidden by their schools from using bathrooms matching their gender identities. The circuit court upheld a lower court’s preliminary injunction that said the schools have to let trans students use facilities associated with their genders.
“Students who are denied access to the appropriate facilities are caused both serious emotional and physical harm as they are denied recognition of who they are,” said ACLU of Indiana lawyer Kenneth Falk. “They will often avoid using the restroom altogether while in school. Schools should be a safe place for kids and the refusal to allow a student to use the correct facilities can be extremely damaging.”
The case involves three trans boys in Martinsville, Indiana and Terre Haute, Indiana, who need access to the boys’ room at their middle and high schools.
One of the boys, identified as A.C. in court documents, is 13 and knew he was a boy since age eight. When he started seventh grade at John R. Wooden Middle School, his stepfather asked that he be allowed to use the boys’ rooms. The school refused and said that A.C. has to use either the girls’ room or a unisex bathroom in the health clinic.
Since he wasn’t out as trans to his classmates, he didn’t want to use the girls’ room. The only accommodation he got was that he wasn’t punished for tardiness when he used the health clinic bathroom. The school suggested he go entirely to online classes just to keep him out of the boys’ restroom.
He felt “depressed, humiliated, and angry” at school and tried to avoid going to be bathroom, which became a major distraction.
The school district actually had a policy to allow some trans students to use the appropriate bathrooms at the district high school, but they told him they couldn’t accommodate him because he’s in middle school.
The other two plaintiffs are 15-year-old twins B.E. and S.E. at Terre Haute North Vigo High School, who both transitioned socially when they were 11. They both also have a colon condition that requires them to take laxatives and have regular access to bathrooms.
They started using the boys’ restrooms in 2021 and no students had a problem with them doing so, the court documents say. But school employees who knew they were trans admonished them. Their mother met with the vice principal, and she was told that the twins had to use the girls’ facilities or a bathroom in the health office.
Since they weren’t out as trans at school, they worried about upsetting the other girls by using the girls’ facilities, and the health office was often locked during parts of the day and far away. B.E. had an accident once because he couldn’t get to the health office in time.
The school’s transgender bathroom policy took numerous factors into consideration and the school’s administration said that trans students needed unspecified surgical changes before they could use the correct bathroom. Gender-affirming surgery is banned for trans people under the age of 18 in Indiana.
The court took into account the fact that Title IX bans discrimination on the basis of sex in schools that receive federal money, which is most of them. Citing the 2020 Supreme Court decision in Bostock v. Clayton Co. that found that job discrimination against LGBTQ+ people necessarily takes sex into account and is therefore prohibited under Title VII, the appeals court ruled that the trans boys are likely to succeed in their case and that preventing them from using the correct bathroom while the case works its way through the court system could cause irreparable harm.
“Litigation over transgender rights is occurring all over the country, and we assume that at some point the Supreme Court will step in with more guidance than it has furnished so far,” Judge Diane Wood wrote for the court in her opinion.
Recent polling shows that Americans increasingly support transphobic bathroom bills, but social science research suggests that this trend could be reversed if more Americans simply came to personally know transgender people.
In a poll released last October, approximately 52% of Americans said they support “bathroom bills” requiring trans people to use facilities matching the sex they were assigned at birth. This was 17% higher than the 35% who supported bathroom bills when the same question was asked in 2016, the Public Religion Research Institute (PRRI) reported.
This increase is most likely due to the recent wave of transphobic legislation and rhetoric by conservatives nationwide. As of July 28, 80 anti-trans bills have been passed in state legislatures in 2023 so far, according to the Trans Legislation Tracker, a 207% increase from the 26 transphobic bills passed in 2022. Many of these laws ban trans people from accessing correct bathrooms, gender-affirming care, or having their identities respected in public schools and other institutions.
However, a June 2023 PRRI survey found that people who know trans people are less likely to agree with transphobic political views. This illustrates a phenomenon known in social science research as “intergroup contact theory.”
The theory states that interpersonal contact with people who are different from one’s self leads to more positive attitudes about those people and a decreased belief in negative stereotypes about them, PRRI CEO Melissa Deckman wrote at The Hill.
For example, in the June 2023 survey, 70% of trans respondents and respondents who are personally close to a trans person said they opposed bans on gender-affirming care for trans children. Comparatively, only 52% of cisgender respondents and those who don’t personally know trans people said that they opposed the bans.
Approximately 35% of respondents who know a trans acquaintance agreed with the conservative view that “young people are being peer pressured into being transgender.” That percentage rose to 49% among respondents who don’t know any transgender people.
Similarly, 20% of respondents who are personally close to a trans person agree that it’s never appropriate to discuss that some people are trans in public schools — a view that has been pushed by the anti-LGBTQ+ group Moms for Liberty and other so-called “parents’ rights” groups. That percentage rose to 41% among respondents who don’t know any transgender people.
In short, the increase in transphobic rhetoric and legislation has been able to thrive because most Americans don’t know actual trans people.
In fact, only 6% to 11% of all respondents in the June 2023 survey said that they have a “close personal relationship” with a trans friend or family member. Comparatively, 40% to 59% of all respondents said that they have a “close personal relationship” with a gay, lesbian, or bisexual friend or family member.
But while the trans community may benefit politically in the long run by building closer relationships with cisgender people, that still presents some challenges. Foremost, some trans people may feel afraid of outing themselves to cis family members, neighbors, and co-workers who may be unsupportive or even hostile to trans individuals.
Four Florida residents filed a motion in federal court yesterday seeking an emergency block on provisions in SB 254 that have created arbitrary, harmful and medically unjustified restrictions on medically-necessary healthcare for transgender adults. Olivia Noel, Kai Pope, Lucien Hamel, and Rebecca Cruz Evia, are all facing dangerous disruptions in their ongoing medical care due to the Florida law.
The motion for preliminary injunction filed yesterday follows the filing of an amended complaint on July 21 expanding the case, Doe v. Ladapo, to challenge state law SB 254’s restrictions on medical care for transgender adults and seeking class-wide relief for all transgender minors and adults who require medical care restricted by SB 254.
“I have been following an established healthcare plan for years, but because of SB 254 my care has suddenly stopped and I can no longer see the provider I trust and who knows my medical history,” said plaintiff Lucien Hamel. “I’m terrified because stopping my care is already having a negative impact on my health and on my family.”
“My physician had to cancel my procedure because of SB 254,” said plaintiff Rebecca Cruz Evia. “I can’t even schedule an appointment with a physician because they are all afraid of this law, even though medical providers have determined this care is medically necessary for me. I’m frustrated and scared about what will happen if I can’t get the care I need.
“I wake up every day feeling like I’m in a nightmare. SB 254 has canceled medically-necessary treatment prescribed for me by my medical team,” said plaintiff Kai Pope. “As a physician myself, SB 254 alarms me not only because of the devastating harm it is causing me and other transgender Floridians, but because of the disruption it is causing to our healthcare system.”
The plaintiffs are represented by Southern Legal Counsel, GLBTQ Legal Advocates & Defenders, the National Center for Lesbian Rights, and the Human Rights Campaign, which issued the following statement:
“SB 254’s restrictions on well-established medical care cause profound harm, serve no legitimate purpose, and reflect gross legislative overreach. SB 254 takes away Floridian’s ability to make important decisions about their own lives and hands it over to the government instead. That should alarm us all.
“In addition to banning established medical care for transgender adolescents and creating criminal and civil penalties for those providing such care, SB 254 enacted severe restrictions on access to care for adults. Advanced Practice Registered Nurse – Nurse Practitioners (APRN-NPs) are critical providers of transgender healthcare in Florida. SB 254 now completely bars them from continuing to treat transgender patients. SB 254 also arbitrarily restricts the use of telehealth for transgender patients and requires in-person consultation for the initial prescription of all transition-related care, a requirement that can be impossible to meet for Florida residents who don’t live near a providing physician. Pursuant to SB 254, the Boards of Medicine have also created mandatory, one-size-fits-all consent forms that defeat the purpose of informed consent by requiring providers to convey false information to their patients and by imposing extremely burdensome, unnecessary, and medically unjustified requirements that transgender patients must meet to obtain even routine transition-related care. Rather than protecting transgender patients, these restrictions intentionally make it difficult or impossible for transgender adults to receive needed medical care.
“These restrictions serve no medical purpose and intentionally prevent transgender people from receiving the care they need.”
The motion filed yesterday by plaintiffs Olivia Noel, Kai Pope, Lucien Hamel, and Rebecca Cruz Evia seeks an emergency block on all provisions in SB 254 and related Boards of Medicine Rules restricting access to established transgender medical care for adults while their legal challenge to SB 254 continues.
The federal district court issued a prior preliminary injunction on June 6 halting enforcement of the ban on healthcare for transgender minors and saying the ban is likely unconstitutional. That order allows Florida parents to access necessary medical care for their transgender children.
Southern Legal Counsel, Inc. (SLC) is a Florida statewide not-for-profit public interest law firm that is committed to the ideal of equal justice for all and the attainment of basic human and civil rights. SLC’s Transgender Rights Initiative protects the rights of Florida’s LGBTQ+ community through federal impact litigation, policy advocacy, and individual representation.www.southernlegal.org
Through strategic litigation, public policy advocacy, and education, GLBTQ Legal Advocates & Defenders (GLAD) works to create a just society free of discrimination based on gender identity and expression, HIV status, and sexual orientation.www.glad.org
The Human Rights Campaign (HRC) is America’s largest civil rights organization working to achieve lesbian, gay, bisexual and transgender equality. HRC envisions a world where LGBTQ+ people are embraced as full members of society at home, at work and in every community.www.hrc.org
The National Center for Lesbian Rights (NCLR) is a national legal organization committed to advancing the human and civil rights of the lesbian, gay, bisexual, transgender, and queer community through litigation, public policy advocacy, and public education. Since its founding, NCLR has maintained a longstanding commitment to racial and economic justice and the LGBTQ community’s most vulnerable.www.nclrights.org
Senate Democrats have introduced legislation that could help transgender and nonbinary people receive accurate credit scores.
The Name Accuracy in Credit Reporting Act, introduced last week by Sens. John Fetterman (D-PA) and Tina Smith (D-MN), would amend the Fair Credit Reporting Act to require credit reporting agencies to only use a person’s current legal name in credit reports, according to The Hill. In March, Rep. Ayanna Pressley (D-MA) marked Transgender Day of Visibility by introducing companion legislation in the House.
As Fetterman’s office noted in a press release announcing the introduction of the legislation, people who legally change their names often face challenges obtaining accurate credit reports and scores. When they apply for credit using their new names, credit bureaus create entirely new credit files. These fragmented credit reports can result in a drop in their credit scores, impacting their ability to access loans, rent homes, and get jobs.
Currently, even when trans and nonbinary people update their credit files, credit agencies can continue to use their deadnames in their credit reports, potentially outing them and exposing them to harassment and discrimination. As The 19th* noted, 27 percent of trans respondents to a recent survey conducted by the Center for LGBTQ Economic Advancement & Research and the Movement Advancement Project said they faced discrimination in banking and financial services.
“Amid the ongoing attacks on the LGBTQ community, I am proud to introduce this bill with Senator Smith that is a commonsense measure to make it easier for people who change their names to obtain accurate credit reports and information,” Fetterman said in a statement. “Whether it’s transgender and nonbinary people or survivors of domestic violence, every American should be able to get an accurate credit report and score.”
“Nobody should face unnecessary burdens to receive a mortgage or a car loan, but transgender and nonbinary Americans have to deal with credit agencies that can’t even get their name right,” said Smith. “This bill fixes a simple issue that Minnesotans have been asking me to help fix, and it will help trans and nonbinary Americans clear a hurdle to accessing loans.”
Fetterman previously raised the issue to the CEOs of Equifax, Experian, and TransUnion—the “big three credit reporting agencies—during an April Senate Committee on Banking, Housing, and Urban Affairs hearing.
Sens. Tammy Baldwin (D-WI), Mazie Hirono (D-HI), Ed Markey (D-MA), Jeff Merkley (D-OR), Patty Murray (D-WA), Bernie Sanders (I-VT), and Brian Schatz (D-HI) joined Fetterman and Smith in co-sponsoring the legislation, which has been endorsed by over a dozen LGBTQ+ and progressive organizations.
An alarming 81% of transgender adults have considered suicide, according to a new studyfrom the Williams Institute at UCLA School of Law. Comparatively, it found 35% of cisgender adults have considered suicide.
The first-of-its-kind study, which appeared in this month’s edition of the journal Psychiatry Research, examined the prevalence of serious drug use, psychological distress, and suicidality among a nationally representative sample of trans and cisgender adults. The study took its data from the U.S. Transgender Population Health Survey (TransPop).
The study found that 42% of trans adults have attempted suicide, compared to just 11% of cis adults. It also found that 56% of trans adults have engaged in non-suicidal self-injury, compared to 12% of cis adults.
Overall, trans people said they were significantly more likely to experience poor mental health during their lifetimes than cis people. However, 82% of trans adults said they had sought mental health treatment at some point, compared to just 47% of cis adults.
While trans and cis adults both reported similar rates of hazardous drinking and problematic drug use, trans nonbinary adults reported the highest rates of substance use.
For example, while 17% of trans women and 25% of trans men reported hazardous drinking, 45% of trans nonbinary people reported the same. While 33% of trans women and 18% of trans men reported problematic drug use, 42% of trans nonbinary people reported the same.
Trans nonbinary adults also reported more problematic drug use, more psychological distress, more suicidal ideation, and more non-suicidal self-injury than trans men, with rates of three to six times greater than that of trans men.
One of the study’s authors, Ilan H. Meyer, said, “A lack of societal recognition and acceptance of gender identities outside of the binary of cisgender man or woman and increasing politically motivated attacks on transgender individuals increase stigma and prejudice and related exposure to minority stress, which contributes to the high rates of substance use and suicidality we see among transgender people.”
Sadly, the study’s findings seem to back up a May 2023 study from The Trevor Project, an LGBTQ+ youth anti-suicide organization. In that study, 66% of queer youth said that anti-LGBTQ+ legislation had negatively affected their mental health, and 41% of LGBTQ+ youth in the U.S. said they’d seriously considered suicide in the last year.
Among suicidal survey respondents, those who identified as transgender, nonbinary, and/or people of color reported higher rates of suicidal ideation than their peers. Rates of anxiety and depression were, on average, 18.5% higher among trans, nonbinary, and questioning youth than among cisgender youth.
In addition to the mental distress, 64% of trans and nonbinary young people reported feeling discriminated against in the past year due to their gender identity, and 27% of trans and nonbinary young people reported being physically threatened or harmed in the past year due to their gender identity.
If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. The Trans Lifeline (1-877-565-8860) is staffed by trans people and will not contact law enforcement. The Trevor Project provides a safe, judgment-free place to talk for youth via chat, text (678-678), or phone (1-866-488-7386). Help is available at all three resources in English and Spanish.
More than 100 transgender men have entered the Miss Italy pageant this week, according to an activist leading a protest against recent comments by the pageant’s organizer, who said trans women wouldn’t be allowed to compete.
The comments came after another European pageant, Miss Netherlands, crowned its first transgender winner, Rikkie Valerie Kollé, this month. About a week later, Patrizia Mirigliani, the official organizer of Miss Italy, told an Italian radio station that Miss Italy wouldn’t allow trans women to compete.
“Lately, beauty contests have been trying to make the news using strategies that I think are a bit absurd,” Mirigliani said, according to the Italian news outlet Il Primato Nazionale.
She added that Miss Italy has historically allowed only people who were assigned female at birth to enter, “probably because, even then, it was foreseen that beauty could undergo modifications, or that women could undergo modifications, or that men could become women,” according to Il Primato Nazionale.
Trans activist Federico Barbarossa, who lives in Bari, a town in southern Italy, said that he became angry when he saw Mirigliani’s comments but that he was “also kind of amused by it, because I was like, ‘Yeah, well, I was assigned female at birth, but they would reject me because I look like a boy, and they would consider me as a boy,’” he said in an interview with NBC News.
Barbarossa decided to enter the pageant under his deadname, or the name he was given at birth, as a form of protest in solidarity with trans women. Barbarossa shared a screenshot of an email he received confirming his registration on Instagram, and then the local LGBTQ nonprofit group he works with, Mixed LGBTQIA+, shared his entry on Facebook with a statement encouraging other trans men to do the same.
The campaign went viral online, Barbarossa said, and he estimates that more than 100 trans men have entered the pageant so far. He said some told him they haveeven been called to selections, which is the next step in the process to find contestants across the country.
Miss Italy organizers “really have to go through every single application,” Barbarossa said. He hopes the protest will “maybe lead them to think better next time.”
“I like to think I’m a little part of Italy’s progress in this sense,” Barbarossa said.
Mirigliani and Miss Italy organizers didn’t immediately respond to requests for comment.
More beauty pageants have started to include trans women in recent years. In 2018, Angela Ponce became the first trans woman to compete in the Miss Universe pageant. Then, in 2021, Kataluna Enriquez became the first trans woman to compete in the Miss USA pageant after she was crowned Miss Nevada. Some countries, such as Mexico and Thailand, have held separate beauty pageants for trans women.
Barbarossa said he thinks beauty pageants try to exclude trans women in part because they simply don’t understand them or have false ideas about what it means to be trans.
For his decision, Durán cited federal court decisions, Title IX of the Education Amendments of 1972, and the Equal Protection Clause of the Fourteenth Amendment.
Virginia’s Department of Education introduced policies last week that would force students to use bathrooms, pronouns, and names that align with their sex assigned at birth. The guidelines went into effect immediately.
“I reaffirm our unwavering support for our LGBTQIA+ students, staff, and community. I want our transgender, non-binary, and gender fluid students to hear loud and clear that you belong here, you are valued, and we stand with and support you,” Durán said.
“I oppose any policy that infringes upon the rights of our students and threatens the safety and well-being of our LGBTQIA+ students. APS will continue to uphold our core mission and follow our policies to ensure that every child receives equal educational access and opportunities. We fully support our transgender and LGBTQIA+ students and value the many diverse identities within our schools, where every student can authentically express themselves, feel valued and have a genuine sense of belonging.”
Youngkin’s 2022 election campaign highlighted “parents’ rights” in opposition to so-called “woke” anti-racist education and trans-inclusive school policies. The VDOE’s new policies will affect the estimated 4,000 transgender students in Virginia among the state’s 1.2 million public school students.
The state’s previous governor enacted policies allowing students to use school facilities and participate in programs matching their gender identities. The earlier policies also required schools to accommodate students’ chosen names and pronouns.
“We will continue to model and live our values in support of inclusion, belonging, well-being, and access to quality education,” Durán told parents. “To this end, our current policies and procedures that protect, affirm, and celebrate transgender, non-binary, and gender-fluid students are of paramount importance in adhering to these ideals.”
Two patients sued Monday in Nashville Chancery Court, saying they were among more than 100 people whose records were sent by Vanderbilt to Attorney General Jonathan Skrmetti. His office has said it is examining medical billing in a “run of the mill” fraud investigation that isn’t directed at patients or their families. Vanderbilt has said it was required by law to comply.
The patients say Vanderbilt was aware that Tennessee authorities are hostile toward the rights of transgender people, and should have removed their personally identifying information before turning over the records.
Tennessee has stood out among conservative-led states pushing myriad laws targeting transgender people, enacting some of the nation’s most anti-LGBTQ restrictions, even as families and advocates have voiced objections that such policies are harmful. The lawsuit seeks class-action status on behalf of everyone at the clinic whose private medical records were released to Skrmetti.
“Against that backdrop, its failure to safeguard the privacy of its patients is particularly egregious,” the lawsuit says.
The attorney general’s office has said the hospital has been providing records of its gender-related treatment billing since December 2022, and that the records have been kept confidential. Elizabeth Lane Johnson, an attorney general’s office spokesperson, noted Tuesday that the office isn’t a party to the lawsuit, and directed questions to Vanderbilt.
VUMC spokesperson John Howser said Tuesday that it’s common for health systems to get such requests in billing probes and audits, and “the decision to release patient records for any purpose is never taken lightly, even in situations such as this where VUMC was legally compelled to produce the patient records.”
Many of the patients involved are state workers, or their adult children or spouses; others are on TennCare, the state’s Medicaid plan; and some were not even patients at the transgender clinic, according to the lawsuit. It says that records for more than 100 current and former patients were sent without redacting their identities.
The lawsuit says that since the patients learned that their information was shared, they’ve been “terrified for their physical safety, have had significant anxiety and distress that has impacted their ability to work, has caused them to increase home security measures, and drop out of activities in which they normally would participate.”
The lawsuit accuses Vanderbilt of negligence that inflicted emotional damage and violated patient privacy protection and consumer protection laws. It seeks monetary damages, improved security procedures, an injunction blocking further release of their records without notice, an acknowledgement by Vanderbilt that it violated its own privacy policy, and an admission that the policy inadequately informs patients of their rights regarding disclosures.
The hospital waited months before telling patients their medical information was shared, acting only after the existence of the requests emerged as evidence in another court case. Howser said that at that point, hospital officials thought patients should hear it from them instead of media reports or other ways.
The attorney general also requested a slew of additional information, including the names of everyone referred to the transgender clinic who made at least one office visit, as well as people who volunteer for the hospital’s Trans Buddy initiative, which aims to increase access to care and improve outcomes by providing emotional support for the clinic’s patients.
Howser said Vanderbilt’s lawyers are in discussion with the attorney general’s office “about what information is relevant to their investigation and will be provided by VUMC.”
The attorney general’s office made the requests several months after conservative commentator Matt Walsh surfaced videos last September that include a medical center doctor saying gender-affirming procedures are “huge money makers” for hospitals. Vanderbilt paused all gender-affirming surgeries for minors the next month under pressure from Republican lawmakers and Gov. Bill Lee, who demanded an investigation.
Vanderbilt said it had provided about five gender-affirming surgeries to minors each year since its clinic opened in 2018, all to people over 16 who had parental consent. None received genital procedures.
When the U.S. Supreme Court revoked the national guarantee of abortion rights last year, there were warnings that the ruling would endanger other rights involving bodily autonomy. And indeed, it’s now being weaponized against gender-affirming care.
The ruling, from the U.S. Court of Appeals for the Sixth Circuit, isn’t the final word on the case; it simply lets the law go into force while the suit against it is heard. But it’s raising concern that other courts might buy the argument or, if federal appellate circuits disagree on the question, the issue of gender-affirming health care could be decided by the Supreme Court — where conservatives currently outnumber liberals by six to three. Vox senior correspondent Ian Millhiser raised this possibility in a recent article.
Representatives of LGBTQ+ organizations, however, say the jury is out, so to speak.
“There’s a high likelihood that these organization and states [behind the care bans] want to push this all the way to the Supreme Court,” Sarah Warbelow, vice president of legal at the Human Rights Campaign, tells The Advocate. Whether they’ll manage to do so, though, “is really hard to say,” she adds.
Sixth Circuit Chief Judge Jeffrey Sutton wrote the opinion placing a hold on the injunction against the Tennessee ban, and he mentioned the Dobbs ruling several times. “If a law restricting a medical procedure that applies only to women does not trigger heightened scrutiny, as in Dobbs, a law equally appliable to all minors, no matter their sex at birth, does not require such scrutiny either,” he wrote in one instance. When a court considers the constitutionality of a law, heightened scrutiny, also known as strict scrutiny, means that the government must prove it has a compelling interest behind the law and that the statute is tailored as narrowly as possible to achieve its goals.
But Judge Helene White, who dissented from Sutton’s ruling, pointed out that the Tennessee ban does treat minors differently based on their sex at birth. It bans gender-affirming procedures for minors who do not identify as the gender assigned at birth but allows them for those who do. “To illustrate, under the law, a person identified male at birth could receive testosterone therapy to conform to a male identity, but a person identified female at birth could not,” she wrote.
Until Sutton wrote his ruling, every federal court that had considered the constitutionality of these laws reached the conclusion that they discriminated based on sex, White observed. Such laws have been temporarily blocked (while cases are heard) in Alabama, Florida, Indiana, and Kentucky because federal judges believed that those who are challenging them are likely to prove such discrimination, and a judge in Arkansas has gone further by striking down that state’s law, the first ruling on such a law’s merits. In a suit in Oklahoma, the state and the challengers have agreed that the law will not be enforced while the case proceeds.
Jennifer Levi, senior director of transgender and queer rights at GLBTQ Legal Advocates and Defenders, says this shows the Sixth Circuit’s ruling is off base. “The states have been citing Dobbsall along, and the courts have rejected that,” Levi says.
On whether there will be a rash of such rulings or the Supreme Court will eventually get involved, she says, “I think it’s really premature to speculate at this point.” GLAD is representing clients challenging the Alabama law and the Florida one; the Alabama trial is scheduled for next spring, while there’s not a definite timetable for the Florida case.
HRC is co-counsel in the Alabama and Florida cases, plus one in Georgia that’s in a very early stage. The Alliance Defending Freedom, an anti-LGBTQ+ legal nonprofit that has won cases at the Supreme Court, including the recent “right to discriminate” case out of Colorado, is working with Alabama officials to defend that state’s ban, and it’s pushing the use of Dobbs, Warbelow notes.
Ultraconservative Justice Samuel Alito, who wrote the Dobbs majority opinion, was very specific that it applied only to abortion, although that didn’t keep fellow conservatives like Justice Clarence Thomas from saying the court should use the same reasoning to strike down marriage equality and other rights. But still, in cases involving gender-affirming care, judges across the political spectrum are blocking or striking down the bans, Warbelow observes.
Ash Orr, press relations manager at the National Center for Transgender Equality, agrees that it’s “premature to form a definitive opinion” about what will happen with the gender-affirming care cases. But the situation bears watching, he says.
If the reasoning used in the Sixth Circuit decision continues to be applied, Orr says, “it could result in significant regression regarding numerous rights.” Beyond the question of whether these bans discriminate, courts must consider whether rights are “deeply rooted in this nation’s history and traditions,” he points out. Judge Sutton asserted that those challenging the Tennessee law had not demonstrated that the right to new medical treatments was deeply rooted.
As various courts rule on the constitutionality of gender-affirming care bans, “it is probable that they will eventually necessitate a comprehensive review by the Supreme Court,” Orr adds. One factor in whether the high court takes a case is whether there is a so-called circuit split — that is, appeals courts in different circuits have ruled differently on an issue.
In the meantime, there are things that not only lawyers and organizations but ordinary citizens can do, beyond supporting the organizations bringing these cases. Warbelow recommends becoming informed about what gender-affirming care for youth consists of and then sharing that information with others.
“Have that conversation with the people in your life,” she says. “We need more people who can spread the word.”
As a 7-year-old, Adelyn Vigil believed death was the way to be able to live as a girl.
Adelyn’s nightly prayer to God was to become a bird to be able to fly, then die and then be made into a girl.
“I was crying and I told her: ‘Oh, but mom, it’s going to take a long time, because first I have to die as a boy and then as a bird and then be a girl,” Adelyn, 14, told Noticias Telemundo about the conversation with her mother years earlier.
“The only thing I could say without crying was: ‘You know you don’t have to die,’” the trans teen’s mother, Adamalis Vigil, said in an interview, recalling the conversation. “I said, ‘If that’s what’s going to make you happy, you can do that. You don’t have to die.’”
Adelyn usually speaks with a smile, except when she starts talking about what makes her afraid: The estrogen hormone treatment she started a year ago is running out and she was left without a doctor after Republican Texas Gov. Greg Abbott signed state Senate Bill14 at the beginning of June. The law bans medical professionals from prescribing drugs to block puberty, hormonal therapies and gender transition surgeries on minors under 18.
The law “is going to be the toughest battle we’re going to face,” Adelyn’s mother said. The advice of a team of specialists and specialized medical care “is what has kept my daughter alive,” she added.
Adelyn is one of nearly 30,000 people ages 13 to 17 who identify as transgender in Texas, according to data from the Williams Institute at the University of California, UCLA. It’s the largest young transgender population of the nearly 20 conservative states that have passed similar laws in recent months.
Adelyn, who wants to be an attorney like Elle Woods (Reese Witherspoon) in “Legally Blonde” when she grows up, wants to move to Washington, D.C., work in human rights and someday be a mom.
“It’s crazy what these legislators are trying to do, someone has to stop them,” Adelyn said about the state bill.
At least 64 bills against trans people have been introduced in Texas and four have passed, according to a count by Trans Legislation Tracker, an advocacy group that tracks these pieces of legislation around the country.
Those who promote and support laws banning gender-affirming care for minors, including puberty blockers and hormones, believe they are too young to make these kinds of decisions about their bodies and that the care is too experimental.
Adelyn spoke to Noticias Telemundo before her 15th birthday on July 24. She was emotional when talking about her quinceañera party — a tradition in Latino families when a young woman turns 15 — and she was excited about her dress, which had crystals, sequins, a bow and a layer of tulle. She bought it in Mexico, where her family is from.
According to Adamalis, the first signs regarding her child’s gender identity came early, when Adelyn was 3 years old. One day, Adamalis was sorting clothes in her closet and Adelyn saw a fuchsia party dress with crystals and asked her mom not to donate it. “When I grow up,” Adelyn told her mom, “I’m going to be a woman and I’m going to wear it.”
Adamalis told the child, “It doesn’t work like that, when you are born and you are a boy, you grow up and become a man,” she said. “And when you are born and you are a girl, you grow up and become a woman. It doesn’t work any other way.”
Adamalis said she tried to get information to understand what was happening and after much searching, she came across articles about trans people. “I had a word for what was happening to Adelyn,” she said.
“I knew I was in the wrong body,” Adelyn said. For Adelyn, there was first a social transition: buying girl’s clothes and shoes, growing her hair, changing her name and telling her family, friends and staff at her school who she was.
“My first instinct was to take her to the doctor,” her mother said. A pediatrician “examined her physically and he was the one who told me: ‘Your first step is going to be to take her to a counselor, a psychologist and talk to the school.’”
Transgender people like Adelyn often experience “a true disconnect between their birth-assigned sex and their inner sense of who they are,” according to the Human Rights Campaign. The anxiety caused by this disconnection has been referred to by doctors as gender dysphoria, since it can cause severe pain and anguish in the lives of trans people.
She was “very sad all the time and would come home and cry,” Adamalis said.
Medical treatments, then a law banning them
For Adelyn, puberty blockers weren’t an option until she was 13 years old; then, after intense and prolonged medical care and assessments, she started hormone therapy with estrogen for a year. The treatments allow her to maintain a finer voice and prevent her from developing masculine features such as a prominent Adam’s apple.
Adelyn said that Texas’ ban on this kind of treatment for minors is “as if the lawmakers are telling you: ‘No, you can’t be you anymore’; ‘wait, wait.’ But if I wait, I will see myself as a man — I don’t want that,” she said, adding that is one of her biggest fears.
Puberty blockers “temporarily stop this process of change and give the adolescent and their family members the opportunity to explore a little more what their options are in the future,” said Dr. Uri Belkind, associate medical director of Adolescent Medicine at the Callen-Lorde Community Health Center in New York.
There are a series of protocols and medical criteria that must be followed before prescribing hormones and they’re not recommended for children who have not yet started puberty, according to the Mayo Clinic.
Puberty blockers, according to the Mayo Clinic, “do not cause permanent physical changes” but may affect growth, bone density and fertility, “although it depends on when the medication is started.” That is why they recommend that each case be evaluated specifically and that patients have a specialized medical team.
“We have enough evidence to say very clearly that these drugs are medically necessary, that they produce benefits, that the benefits outweigh the risks, and that, in one way or another, they improve quality of life and even save lives,” Belkind said.
That’s why the bill worries Adamalis.
“Of all the battles, I think this is the worst, because this kind of help is what has kept my daughter alive,” Adamalis said about her daughter. “When I found her [medical] team, she was happy. Her anxiety went away, her panic attacks went away,” Adamalis said.
Laws like the one in Texas, said Belkind, prevent medical professionals like him from providing patients the care they need, and by not having access, “they see their body getting further and further and further away from the idea that they have of themselves.”
This is dangerous because it generates anxiety, depression and stress. “We know that suicide rates increase in patients who don’t have access to this type of medication,” Belkind said.
Adelyn and her family would drive eight hours for appointments with the endocrinologist who was supervising her transition along with a team of experts. A few days ago, they got a letter from the endocrinologist saying that they could no longer treat her. The doctor was moving to California, the doctor confided to the family, because of the situation in Texas.
As a family, they’re considering traveling to New Mexico or Mexico to seek medical advice that is being denied at home. Adelyn doesn’t want to live in Texas but her mother said that, unfortunately, moving is currently not a possibility.
Adamalis said that the medical treatment they were able to get up to now “has given us the best years of Adelyn,” but that now she feels afraid and helpless.
She asks politicians to “educate themselves on the issue, but more than anything, to focus on what the problem really is: immigration reform, getting better health insurance, gun reform.”
Trans children and adolescents “are not the problem,” Adamalis said.
‘It has saved our entire family’
Juan is going to be 10 years old and identifies as trans. Due to his age, he’s only experienced a social transition with the support of his family, who is of Mexican origin, and a medical team that includes psychologists and counselors. The family lives in California, a state that, unlike Texas, has passed legislation to protect the legal and medical rights of LGBTQ+ people.
Juan’s transition began three years ago, although “from a very young age, from a very young age, around 2 years old — he always identified himself as a masculine,” his mother, Grisel Soriano, told Noticias Telemundo.
The process, she said, hasn’t been easy. “We went through a very complex emotional situation … because we didn’t really understand what was happening,” Soriano said.
For two years, the family tried to find alternatives, such as taking refuge in religion, but “we really started the transition out of survival,” Soriano said, adding that at the age of 6 “Juan had already had thoughts of death.”
His clothes, his hair, his name, made him suffer, Soriano said. “He didn’t like the gender that we were forcing him to live in at all.”
The family, guided by a team of medical experts, has supported Juan, although his mother feels that as parents they are judged and recriminated by a society that doesn’t understand them.
“It’s difficult to understand a trans family. It’s difficult to understand a trans child when you do not have one at home … until we hear our children say that they would be better off dead,” Soriano said.
Soriano believes that there are many myths surrounding trans children and their families. “They judge us as if one day our children decided to be trans children and we say happily, we are going to help them … We went through a difficult process and we do it from affection, from love,” she said.
Families, especially parents, go through a process similar to the stages of grief: shock, denial, anger, negotiation and acceptance, wrote Jason Rafferty, a pediatrician and psychiatrist at the American Academy of Pediatrics.
Rejecting and suppressing trans minors won’t make them change their gender identity, Rafferty wrote, but it harms the child’s emotional health and development and possibly contributes to high rates of depression, anxiety and other mental health problems.
Nearly 600 anti-trans bills have been promoted across the country in 2023, according to the Trans Legislation Tracker‘s count. By contrast, only 19 bills were promoted in 2015.
Juan’s transition — he chose his name — “has been happiness for him,” his mother said. “After we started the transition, I saw him comfortable, I saw him happy, I saw him content … The transition has saved not only Juan, it has saved our entire family.”
Juan, whose favorite sport is American football, wants to be a doctor when he grows up. “I want to help children who are trans too,” he said.
He wanted to tell his story so that other children like him know that “everything will be fine.”